• Sijuan Sun, Hong Ren, Ying Wang, Jian Zhang, Biru Li, Botao Ning, and Juan Qian.
• All authors: Department of Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
• Pediatr Crit Care Me. 2020 May 1; 21 (5): e247-e252.

ObjectivesTo investigate whether respiratory variations in aortic blood flow by echocardiography can accurately predict volume responsiveness in ventilated children with leukemia and neutropenic septic shock.DesignA prospective study.SettingA 25-bed PICU of a tertiary hospital.PatientsMechanically ventilated children with leukemia who had been exposed to anthracyclines and exhibited neutropenic septic shock were enrolled.InterventionsTransthoracic echocardiography was performed to monitor the aortic blood flow before and after fluid administration.Measurements And Main ResultsAfter volume expansion, left ventricular stroke volume increased by greater than or equal to 15% in 16 patients (responders) and less than 15% in 14 patients (nonresponders). The performance of respiratory variation in velocity time integral of aortic blood flow and respiratory variation in peak velocity of aortic blood flow for predicting volume responsiveness, as determined by the area under the receiver operating characteristic curve, was 0.74 (95% CI, 0.55-0.94; p = 0.025) and 0.71 (95% CI, 0.53-0.90; p = 0.048), respectively. Positive end-expiratory pressure was higher in nonresponders than in responders (p = 0.035).ConclusionsRespiratory variation in velocity time integral of aortic blood flow and respiratory variation in peak velocity of aortic blood flow derived from transthoracic echocardiography showed only a fair reliability in predicting volume responsiveness in ventilated children with leukemia and neutropenic septic shock.

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